Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Pediatric Transplants

Social outcome in children treated by haematopoietic cell transplant for congenital immunodeficiency

Abstract

Previous studies have reported increased rates of social difficulties in children treated by haematopoietic cell transplant (HCT). This study assessed social functioning in children with congenital immunodeficiency treated by HCT and investigated two potential underlying mechanisms that may explain social difficulties: executive function skills and physical appearance. In total, 31 children (8–16 years of age) were assessed on measures of social functioning and peer relationships, executive function and physical appearance. Results were compared with a control group of 31 healthy children, matched for age, gender, ethnicity and cognitive ability. Parent, teacher and self-report data were collected. HCT survivors were described by parents and teachers, but not by themselves, as experiencing more difficulties with social functioning than the control group. Executive function was not associated with social functioning. However, an objective measure of physical appearance was significantly associated with social functioning. Results suggest that children treated by HCT for congenital immunodeficiency do experience significant difficulties in social functioning, not solely accounted for by below average intelligence. These difficulties are associated with physical appearance, but not with executive functional skills. This has clinical implications for identifying and treating children at increased risk of difficulties with social functioning.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Rogers MH, Lwin R, Fairbanks L, Gerritsen B, Gaspar HB . Cognitive and behavioral abnormalities in adenosine deaminase deficient severe combined immunodeficiency. J Pediatr 2001; 139: 44–50.

    Article  CAS  PubMed  Google Scholar 

  2. Titman P, Pink E, Skucek E, O’Hanlon K, Cole TJ, Gaspar J et al. Cognitive and behavioural abnormalities in children following haematopoietic stem cell transplantation for severe congenital immunodeficiencies. Blood 2008; 112: 3907–3913.

    Article  CAS  PubMed  Google Scholar 

  3. Deater-Deckard K . Annotation: recent research examining the role of peer relationships in the development of psychopathology. J Child Psychol Psychiatry 2001; 42: 565–579.

    Article  CAS  PubMed  Google Scholar 

  4. Parker JG, Asher SR . Peer relations and later personal adjustments: Are low accepted children at risk? Psychol Bull 1987; 102: 357–389.

    Article  CAS  PubMed  Google Scholar 

  5. Arvidson J, Larsson B, Lonnerholm G . A long term follow up study of psychosocial functioning after autologous bone marrow transplantation in childhood. Psycho-Oncology 1999; 8: 123–134.

    Article  CAS  PubMed  Google Scholar 

  6. Kupst MJ, Penati B, Debban B, Camitta B, Pietryga D, Margolis D et al. Cognitive and psychosocial functioning of pediatric hematopoietic stem cell transplant patients: A prospective longitudinal study. Bone Marrow Transplant 2002; 30: 609–617.

    Article  CAS  PubMed  Google Scholar 

  7. Phipps S, Dunavant M, Srivastava DK, Bowman L, Mulhern RK . Cognitive and academic functioning in survivors of pediatric bone marrow transplantation. J Clin Oncol 2000; 18: 1004–1011.

    Article  CAS  PubMed  Google Scholar 

  8. Phipps S, Mulhern RK . Family cohesion and expressiveness promote resilience to the stress of pediatric bone marrow transplant: a preliminary report. Dev Behav Pediatr 1995; 16: 257–263.

    Article  CAS  Google Scholar 

  9. Vanatta K, Zeller M, Noll RB, Koontz K . Social functioning of children surviving bone marrow transplantation. J Pediatr Psychol 1998; 23: 169–178.

    Article  Google Scholar 

  10. Phipps S, Rai S, Leung WH, Lensing S, Dunavant M . Cognitive and academic consequences of stem-cell transplantation in children. J Clin Oncol 2008; 26: 2027–2033.

    Article  PubMed  Google Scholar 

  11. Noll RB, Gartstein MA, Vanatta K, Correll J, Bukowski WM, Davies WH . Social, Emotional and Behavioural Functioning of Children with Cancer. Pediatrics 1999; 103: 71–78.

    Article  CAS  PubMed  Google Scholar 

  12. Reiter-Purtill J, Gerhardt CA, Vanatta K, Passo MH, Noll RB . A controlled longitudinal study of the social functioning of children with juvenile rheumatoid arthritis. J Pediatr Psychol 2003; 28: 17–28.

    Article  PubMed  Google Scholar 

  13. Booth-Jones M, Jacobsen PB, Ransom S, Soety E . Characteristics and correlates of cognitive functioning following bone marrow transplantation. Bone Marrow Transplant 2005; 36: 695–702.

    Article  CAS  PubMed  Google Scholar 

  14. Harder H, Cornelisson JJ, Van Gool AR . Cognitive functioning and quality of life in long-term adult survivors of bone marrow transplantation. Cancer 2002; 95: 183–192.

    Article  PubMed  Google Scholar 

  15. Fisher J, Barkley R, Smallish L, Fletcher K . Executive functioning in hyperactive children as young adults: Attention, inhibition, response perseveration, and the impact of comorbidity. Dev Neuropsychol 2005; 27: 107–133.

    Article  Google Scholar 

  16. Seguin JR, Boulerice B, Hardin PW, Tremblay RE, Phil RO . Executive functions and physical aggression after controlling for attention deficit hyperactivity disorder, general memory, and IQ. J Child Psychol Psychiatry 1999; 40: 1197–1208.

    Article  CAS  PubMed  Google Scholar 

  17. Lopez BR, Lincoln AJ, Ozonoff S, Lai Z . Examining the relationships between executive functions and restrictive, repetitive symptoms of autistic disorder. J Autism Dev Disord 2005; 35: 445–460.

    Article  PubMed  Google Scholar 

  18. Hartup WW . Peer relations. In: Hetherington EM (ed.). Handbook of Child Psychology: Vol. 4. Socialization, Personality and Social Development. Wiley: New York, 1993, pp 102–196.

    Google Scholar 

  19. Reiter-Purtill J, Waller JM, Noll RB . Empirical and theoretical perspectives on the peer relationships of children with chronic conditions. In: Roberts MC and Steele RG (eds). Handbook of Pediatric Psychology, 4th edn, Chapter 45. Guildford Press: London, 2009.

    Google Scholar 

  20. Nadeau L, Tessier R . Social adjustment of children with cerebral palsy in mainstream classes: Peer perception. Dev Med Child Neurol 2006; 48: 331–336.

    Article  PubMed  Google Scholar 

  21. Wechsler D . Wechsler Intelligence Scale for Children, 3rd edn. Psychological Corporation: UK, 1991.

    Google Scholar 

  22. Goodman R . The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatr 1997; 38: 581–586.

    Article  CAS  Google Scholar 

  23. Goodman R, Ford T, Richards H, Gatward R, Meltzer H . The development and well-being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatr 2000; 41: 645–655.

    Article  CAS  Google Scholar 

  24. Sparrow SS, Balla DA, Cicchetti DV . Vineland Adaptive Behaviour Scales: Interview Edition Survey form Manual. American Guidance Service: Circle Pines: MN, 1984.

    Google Scholar 

  25. Rubia K, Smith A, Taylor E . Performance of children with attention deficit hypperactivity disorder (adhd) on a test battery of impulsiveness. Child Neuropsychol 2007; 13: 276–304.

    Article  PubMed  Google Scholar 

  26. Korkman M, Kirk U, Kemp S . NEPSY: A Developmental Neuropsychological Assessment, Manual. The Psychological Corporation: UK, 1998.

    Google Scholar 

  27. Cohen J . Statistical Power Analysis for the Behavioural Sciences, 2nd edn. Lawrence Earlbaum Associates: Hillsdale, NJ, 1988.

    Google Scholar 

  28. Benjamini Y, Hochberg Y . Controlling for false discovery rate—A practical and powerful approach to multiple testing. J R Stat Soc B Met 1995; 57: 289–300.

    Google Scholar 

  29. Canning EH, Canning RD, Boyce WT . Depressive symptoms and adaptive style in children with cancer. J Am Acad Child Adolesce Psychiatry 1992; 32: 1120–1124.

    Article  Google Scholar 

  30. Cicchetti D, Cohen DJ . Perspectives on developmental psychopathology. In: Cicchetti D & Cohen DJ (eds). Developmental Psychopathology: Vol. 1. Theory and Methods. Wiley: New York, 1995, pp 3–20.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E Skucek.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Skucek, E., Butler, S., Gaspar, H. et al. Social outcome in children treated by haematopoietic cell transplant for congenital immunodeficiency. Bone Marrow Transplant 46, 1314–1320 (2011). https://doi.org/10.1038/bmt.2010.318

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2010.318

Keywords

This article is cited by

Search

Quick links